MANILA, Philippines - Human error and lack of leadership among the crew of the USS Guardian were some of the factors that led to the grounding of the ill-fated ship at the world-renowned Tubbataha Reef in waters off Palawan, the US Navy revealed on Friday.

Over five months after the incident, the US Navy finally released the results of its investigation that assessed circumstances surrounding the USS Guardian grounding last January 17.

In a 160-page report, the US Navy said the grounding of the USS Guardian was "entirely preventable" and its root causes were human error and a "failure of leadership to provide adequate oversight and direction in planning and executing the Navigation Plan."

The incident was the product of" poor voyage planning, poor execution, and unfortunate circumstances," according to the report.

"This investigation uncovers no single point of failure; instead, there were numerous links in the error chain leading up to the grounding. Had any one of which been appropriately addressed, the grounding would have been prevented," the report said.

Admiral Cecil Haney, commander of the US Pacific Fleet, wrote in the report that the USS Guardian leadership and watch teams failed to adhere to "prudent, safe, and sound navigation principles which would have alerted them to approaching dangers with sufficient time to take mitigating action,"

"Finally, USS GUARDIAN leadership failed to exercise due diligence to ensure the watch teams were knowledgeable and proficient, and failed to recognize that key personnel transfers within the navigation team had degraded USS GUARDIAN's navigation capability to an unacceptable level. Ultimately, the lack of leadership led to increased navigational risk to the ship and her crew," the report further explained.

Calling the grounding a "tragic mishap," Haney summarized that a "lack of leadership" led to the watch team's disregard of visual cues, electronic cues and alarms in the hours leading up to the incident.

"Ultimate reliance" on inaccurate Digital Nautical Charts during the planning and execution of the navigation plan also led to a degradation of the ship's navigation ability, according to the Navy official.

The Avenger-class mine countermeasures ship had just completed a port call in Subic Bay and was en route to Indonesia when the grounding occurred.

The vessel was subsequently dismantled, decommissioned and stricken from the naval registry. The shipwreck was removed from Tubbataha Reef last March 30.

The ship's commanding officer, Lt. Cmdr. Mark Rice; Lt. Daniel Tyler, the assistant navigator; and the officer of the deck at the time of the grounding were relieved of their duties.

The US Navy report, recommended, among other things, a thorough command readiness inspection of the USS Guardian crew to include an emphasis on divisional/departmental training and personnel qualification standards.

Mandatory requirements for reporting safety of navigation-related discrepancies identified in Digital Nautical Charts were also recommended to be established.

An investigation to be made on the emergency destruction process and procedures used in the USS Guardian incident was also suggested.

The US Navy is facing a P58-million ($1.4-million) fine after the minesweeper damaged 2,345.67 square meters of Tubbataha reef, a UNESCO World Heritage site. The amount is based on fines stipulated in Republic Act No. 10067 or the Tubbataha Reefs Natural Park Act of 2009.